Validation of the extended thrombolysis in cerebral infarction score in a real world cohort
2019 | journal article. A publication with affiliation to the University of Göttingen.
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Validation of the extended thrombolysis in cerebral infarction score in a real world cohort
Behme, D. ; Tsogkas, I. ; Colla, R. ; Gera, R. G. ; Schregel, K. ; Hesse, A. C. & Maier, I. L. et al. (2019)
PLOS ONE, 14(1) art. e0210334. DOI: https://doi.org/10.1371/journal.pone.0210334
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Details
- Authors
- Behme, Daniel ; Tsogkas, Ioannis ; Colla, Ruben ; Gera, Roland G. ; Schregel, Katharina ; Hesse, Amélie C.; Maier, Ilko L. ; Liman, Jan ; Liebeskind, David S.; Psychogios, Marios-Nikos
- Abstract
- BACKGROUND: A thrombolysis in cerebral infarction (TICI) score of 2b is defined as a good recanalization result although the reperfusion may only cover 50% of the affected territory. An additional mTICI2c category was introduced to further differentiate between mTICI scores. Despite the new mTICI2c category, mTICI2b still covers a range of 50-90% reperfusion which might be too imprecise to predict neurological improvement after therapy. AIM: To compare the 7-point "expanded TICI" (eTICI) scale with the traditional mTICI in regard to predict functional independence at 90 days. METHODS: Retrospective review of 225 patients with large artery occlusion. Angiograms were graded by 2 readers according the 7-point eTICI score (0% = eTICI0; reduced clot = eTICI1; 1-49% = eTICI2a, 50-66% = eTICI2b50; 67-89% = eTICI2b67, 90-99% = eTICI2c and complete reperfusion = eTICI3) and the conventional mTICI score. The ability of e- and mTICI to predict favorable outcome at 90days was compared. RESULTS: Given the ROC analysis eTICI was the better predictor of favorable outcome (p-value 0.047). Additionally, eTICI scores 2b50, 2b67 and 2c (former mTICI2b) were significantly superior at predicting the probability of a favorable outcome at 90 days after endovascular therapy with a p-value of 0.033 (probabilities of 17% for mTICI2b50, 24% for mTICI2b67 and 54% for mTICI2c vs. 36% for mTICI2b). CONCLUSIONS: The 7-point eTICI allows for a more accurate outcome prediction compared to the mTICI score because it refines the broad range of former mTICI2b results.
- Issue Date
- 2019
- Journal
- PLOS ONE
- ISSN
- 1932-6203
- Language
- English